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Epidemiology

Association between the 10-year predicted risk of atherosclerotic cardiovascular disease and dietary patterns among Canadian adults 40–79 years

European Journal of Clinical Nutrition volume 75, pages 636–644 (2021)Cite this article

Subjects

Abstract

Background/objectives

Identifying groups at risk for atherosclerotic cardiovascular disease (ASCVD) and improving prevention strategies are important due to the high rates of these diseases in the world. We aimed to determine the 10-year ASCVD risk and cardiovascular age gap (CAG) of Canadians 40–79 and the association between prevalent dietary patterns and ASCVD risk, and CAG.

Subjects/methods

Health measures and dietary intake information were obtained from 2088 respondents representative of 13,655,671 Canadians 40–79 years in the cross-sectional Canadian Health Measures Survey Cycles 1 and 2 (2007–11). The estimated 10-year ASCVD risk and CAG were determined for 40–79 years adults across different levels of sociodemographic/lifestyle factors. Dietary patterns emerged using the principal component analysis from 32 food groups collected using food frequency questionnaire. The association between 10-year ASCVD risk, and CAG, with dietary patterns was investigated controlling for potential covariates. Survey data were weighted and bootstrapped to be nationally representative.

Results

The mean 10-year ASCVD risk of 40–79 years was 6.9%. The mean CAG for men was −4.1 years (older) and for females was +0.4 years (younger). Four dietary patterns emerged. Of note, the “High carbohydrate and protein” dietary pattern, which included potatoes, red meat, sausage, egg and ice-cream/frozen yoghurt was positively associated with 10-year ASCVD (Ptrend = 0.013). The “Healthy like” and “Fast food” dietary patterns had an inverse (p < 0.0001) and positive (p = 0.005) association, respectively, with CAG.

Conclusions

Dietary patterns prevalent among this population were associated with CAG and ASCVD risk. Interventions for promoting healthy dietary patterns may be beneficial to reduce ASCVD in Canada.

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References

  1. Statistics Canada. Table 13-10-0394-01. Leading causes of death, total population, by age group. Ottawa, ON, Canada: Statistics Canada; 2012. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401.

  2. Reiner Ž, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818. https://doi.org/10.1093/eurheartj/ehr158.

    Article  PubMed  Google Scholar 

  3. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2935–59. https://doi.org/10.1016/j.jacc.2013.11.005.

    Article  PubMed  Google Scholar 

  4. D’agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circ J. 2008;117:743–53. https://circ.ahajournals.org/content/117/6/743.ful.

  5. Cuende JI. Vascular age versus cardiovascular risk: clarifying concepts. Rev Esp Cardiol (English edition). 2016;69:243–6.

  6. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13:3–9.

    Article  CAS  Google Scholar 

  7. Sonnenberg L, Pencina M, Kimokoti R, Quatromoni P, Nam BH, D’Agostino R, et al. Dietary patterns and the metabolic syndrome in obese and non-obese Framingham women. Obes Res. 2005;13:153–62.

    Article  Google Scholar 

  8. Expert Panel on Detection, E. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486.

    Article  Google Scholar 

  9. Freeland-Graves J, Nitzke S. Position of the American Dietetic Association: total diet approach to communicating food and nutrition information. J Am Diet Assoc. 2002;102:100–8.

    Article  Google Scholar 

  10. Statistics Canada. Canadian Health Measures Survey—data user guide: cycle 1, definitions, data sources and methods. Ottawa, ON, Canada: Statistics Canada; 2012. http://www23.statcan.gc.ca/imdb-bmdi/document/5071_D2_T1_V1-eng.htm.

  11. Statistics Canada. Canadian Health Measures Survey (CHMS) Data User Guide: Cycle 2. Ottawa, ON, Canada: Statistics Canada; 2012. http://data.library.utoronto.ca/datapub/codebooks/cstdli/chms/CHMS_User_Guide_Cycle2_E.pdf.

  12. Statistics Canada. Canadian Health Measures Survey (CHMS): instructions for combining cycle 1 and cycle 2 data. Ottawa, ON, Canada: Statistics Canada; 2014. Available at Research Data Center.

  13. Hosseini Z, Whiting SJ, Vatanparast H. Type 2 diabetes prevalence among Canadian adults—dietary habits and sociodemographic risk factors. Appl Physiol Nutr Metab. 2019;44:1099–104.

    Article  Google Scholar 

  14. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circ J. 2009;120:1640–5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644.

    Article  CAS  Google Scholar 

  15. Hennessy DA, Bushnik T, Manuel DG, Anderson TJ. Comparing guidelines for statin treatment in Canada and the United States. JAMA. 2015;4:e001758.

    Google Scholar 

  16. Tucker KL. Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab. 2010;35:211–8.

    Article  Google Scholar 

  17. Statistics Canada. Canadian Health Measures Survey—Data Dictionary: Cycle 1. Ottawa, ON, Canada: Statistics Canada; 2010. http://www.library.carleton.ca/sites/default/files/find/data/surveys/pdf_files/chms-c1-07-09-dic.pdf.

  18. Yang Q, Zhong Y, Ritchey M, Cobain M, Gillespie C, Merritt R, et al. Vital signs: predicted heart age and racial disparities in heart age among US adults at the state level. MMWR Morb Mortal Wkly Rep. 2015;64:950–8.

    Article  Google Scholar 

  19. Hosseini Z, Whiting SJ, Vatanparast H. Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective. Nutr Res Rev. 2016;29:152–62.

    Article  Google Scholar 

  20. Movassagh EZ, Vatanparast H. Current evidence on the association of dietary patterns and bone health: a scoping review. Adv Nutr. 2017;8:1–6.

    Article  CAS  Google Scholar 

  21. Nettleton JA, Polak JF, Tracy R, Burke GL, Jacobs DR Jr. Dietary patterns and incident cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2009;90:647–54.

    Article  CAS  Google Scholar 

  22. Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM, et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2006;83:1369–79.

    Article  CAS  Google Scholar 

  23. Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr. 2000;72:912–21.

    Article  CAS  Google Scholar 

  24. Fung TT, Stampfer MJ, Manson JE, Rexrode KM, Willett WC, Hu FB. Prospective study of major dietary patterns and stroke risk in women. Stroke. 2004;35:2014–9.

    Article  Google Scholar 

  25. Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med. 2006;354:1601–13.

    Article  CAS  Google Scholar 

  26. Deshmukh-Taskar PR, O’Neil CE, Nicklas TA, Yang SJ, Liu Y, Gustat J, et al. Dietary patterns associated with metabolic syndrome, sociodemographic and lifestyle factors in young adults: the Bogalusa Heart Study. Public Health Nutr. 2009;12:2493–503.

    Article  Google Scholar 

  27. Adlercreutz H. Western diet and Western diseases: some hormonal and biochemical mechanisms and associations. Scand J Clin Lab Investig. 1990;50:3–23.

    Article  Google Scholar 

  28. Hosseini Z, Whiting SJ, Vatanparast H. Canadians’ Dietary Intake from 2007 to 2011 and across Different Sociodemographic/Lifestyle Factors Using the Canadian Health Measures Survey Cycles 1 and 2. J Nutr Metab. 2019. https://doi.org/10.1155/2019/28319.

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Acknowledgements

Authors of this study acknowledge Saskatchewan Research Data Centre at the University of Saskatchewan for providing opportunity to access the nationally representative CHMS datasets.

Funding

This paper is supported by University of Saskatchewan and a contribution from the Dairy Research Cluster Initiative (Dairy Farmers of Canada, Agriculture and Agri-Food Canada, the Canadian Dairy Network and the Canadian Dairy Commission) (grant number AIP-CL04). The funders had no contribution in any part of this research or any part of the preparation of this paper.

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Authors and Affiliations

  1. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada

    Zeinab Hosseini, Arash Shamloo, Susan J. Whiting & Hassan Vatanparast

  2. Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Mehdi Rostami

Authors
  1. Zeinab Hosseini
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  2. Mehdi Rostami
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  4. Susan J. Whiting
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  5. Hassan Vatanparast
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Contributions

ZH was responsible for preparing the research question(s), conducting analysis, designing the study and writing the paper. MR and AS conducted analysis. SW prepared the research question(s), conducted analysis, designed the study and wrote the paper. HV prepared the research question(s), conducted analysis, designed the study and wrote the paper.

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Correspondence to Hassan Vatanparast.

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Hosseini, Z., Rostami, M., Shamloo, A. et al. Association between the 10-year predicted risk of atherosclerotic cardiovascular disease and dietary patterns among Canadian adults 40–79 years. Eur J Clin Nutr 75, 636–644 (2021). https://doi.org/10.1038/s41430-020-00763-8

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